Volume 81, Issue 1, Pages (January 1982)

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Presentation transcript:

Volume 81, Issue 1, Pages 91-94 (January 1982) Left Atrial-to-Right Atrial Shunt without Atrial Septal Defect or Precordial Murmur Frank C. Brosius, M.D., David E. Schwartz, M.D., William L. Gleason, M.D., Barry Maron, M.D., Michael Jones, M.D., William C. Roberts, M.D., F.C.C.P. CHEST Volume 81, Issue 1, Pages 91-94 (January 1982) DOI: 10.1378/chest.81.1.91 Copyright © 1982 The American College of Chest Physicians Terms and Conditions

Figure 1 Electrocardiograms recorded at ages 32, 47 and 49 years, respectively (top to bottom). CHEST 1982 81, 91-94DOI: (10.1378/chest.81.1.91) Copyright © 1982 The American College of Chest Physicians Terms and Conditions

Figure 2 Posteroanterior (left) and lateral roentgenograms (middle) taken two weeks before death, and the left lung (right) at necropsy with the pulmonary varix dissected free. The pulmonary varix is seen well in both radiographs. CHEST 1982 81, 91-94DOI: (10.1378/chest.81.1.91) Copyright © 1982 The American College of Chest Physicians Terms and Conditions

Figure 3 Echocardiogram recorded a week before death. The ventricular septum (VS) measures 15 mm and the left ventricular free wall, 14 mm in thickness. Both right (RV) and left ventricular cavities are dilated. A pericardial effusion (PE) is present MV = mitral valve. CHEST 1982 81, 91-94DOI: (10.1378/chest.81.1.91) Copyright © 1982 The American College of Chest Physicians Terms and Conditions

Figure 4 Diagram of the pulmonary varix and its connection to left atrium and to an anomalous systemic vein. The flow of blood in the varix is reverse of that which might have been expected had the heart been normal. IVC = inferior vena cava; LA = left atrium; LV = left ventricle; RA = right atrium; RV = right ventricle and SVC = superior vena cava. CHEST 1982 81, 91-94DOI: (10.1378/chest.81.1.91) Copyright © 1982 The American College of Chest Physicians Terms and Conditions

Figure 5 The heart a anteroposterior cut (similar to that of the M-mode echo beam) showing the relative thickness of the right ventricular (RV), ventricular septal (VS) and left ventricular (LV) walls and the sizes of the ventricular cavities. A = anterior leaflet of the mitral valve; LA = left atrium; RA = right atrium, b close-up of mitral valve area. The most basal portion of left ventricular free wall is thinner than that in the mid-portion, the reverse of normal. A subepicardial scar, a fairly frequent occurrence in hypertrophic cardiomyopathy, is partially enclosed by brackets and a close-up photomicrograph (X16) of the area in brackets is shown in d. c A more anterior cut of the ventricles showing many transmural ventricular scars (arrows). CHEST 1982 81, 91-94DOI: (10.1378/chest.81.1.91) Copyright © 1982 The American College of Chest Physicians Terms and Conditions